Individual provider Active NPI

Christopher P Birdsall, MD

  • Urology Physician
  • Peabody, MA
National Provider Identifier
1770511586
Registry record updated Jun 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
55899 Issued in MA
Practice address
1 Essex Center Dr
Peabody, MA 01960-2901
Phone
(978) 538-4180
Fax
(978) 538-4148
NPI assigned
Jun 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 55899 MA Primary

Addresses

Primary practice location

1 Essex Center Dr
Peabody, MA 01960-2901

Mailing address

1 Essex Center Dr
Peabody, MA 01960-2901
Phone (978) 538-4180

Other identifiers 1

IdentifierTypeStateIssuer
3050041MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050105000420 MA Practitioner - Urology 8820046097 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
55899MAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Steward Medical Group, Inc CurrentSince May 1, 2011 Accepting new patients
Steward Medical Group, Inc CurrentSince May 1, 2011 Accepting new patients
Merrimack Valley Health Care Group Past Accepting new patients

Locations

11 Nevins St
Ste 201
Brighton, MA 02135
Phone (617) 789-2442

140 Lincoln Ave
Haverhill, MA 01830
Phone (978) 374-2000

100 Amesbury St
Ste 103
Lawrence, MA 01840
Phone (978) 683-0157

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464912000000",
    "number": "1770511586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ESSEX CENTER DR",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019602901",
            "telephone_number": "978-538-4180",
            "fax_number": "978-538-4148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ESSEX CENTER DR",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019602901",
            "telephone_number": "978-538-4180",
            "fax_number": "978-538-4148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIRDSALL",
        "first_name": "CHRISTOPHER",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2016-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MA",
            "license": "55899",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3050041",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peabody, MA

Sources for this page

Verify at the official NPI Registry.